Once-a-month diabetes treatment may replace daily insulin jabs

Scientists, including one of Indian origin, have developed a technology that may provide weeks of glucose control for diabetes with a single injection, which would be a dramatic improvement over current therapies. In primates, the treatment has been shown to last for weeks, rather than days, researchers at Duke University in the US said. By creating a controlled-release mechanism for a drug and optimising its circulation time in the body, the new biopolymer injection has the potential to replace daily or weekly insulin shots with a once-a-month or twice-a-month treatments for type 2 diabetes, they said.

Many current treatments for type 2 diabetes use a signalling molecule called glucagon-like peptide-1 (GLP1) to cause the pancreas to release insulin to control blood sugar. However, this peptide has a short half-life and is cleared from the body quickly. Researchers, including Ashutosh Chilkoti, from Duke University, have created a technology that fuses GLP1 to a heat-sensitive elastin-like polypeptide (ELP) in a solution that can be injected into the skin through a standard needle. Once injected, the solution reacts with body heat to form a biodegradable gel-like “depot” that slowly releases the drug as it dissolves.

In animal experiments, the resulting therapy provided glucose control up to three times longer than treatments currently on the market. Researchers systematically worked to vary the design of the delivery biopolymer at the molecular level and found a sweet spot that maximised the duration of the drug’s delivery from a single injection. “By doing so, we managed to triple the duration of this short-acting drug for type 2 diabetes, outperforming other competing designs,” said Chilkoti, senior author of study published in the journal Nature Biomedical Engineering. Researchers optimised their solution to regulate glucose levels in mice for 10 days after a single injection, up from the previous standard of 2-3 days.

In further tests, the team found that the optimised formulation improved glucose control in rhesus monkeys for more than 14 days after a single injection, while also releasing the drug at a constant rate for the duration of the trial. “What is exciting about this work was our ability to demonstrate that the drug could last over two weeks in non- human primates,” said Kelli Luginbuhl, a PhD student in the Chilkoti lab and co-author of the study.